Nutrition Curriculum Guide for Training Physician
                  Practice Behavior Skills and Attitudes Across the Curriculum
              Prepared by:
              CURRICULUMCOMMITTEEofthe
              NUTRITIONACADEMICAWARDPROGRAM
              National Institutes of Health Staff
              Elaine Stone, PhD, MPH, Advisor, Program Officer (1998-2001)
              Marcel Salive, MD, Advisor, Program Officer (2001-2003)
              National Heart, Lung & Blood Institute (NHLBI)
              National Institute of Diabetes, Digestive & Kidney Diseases (NIDDK)
              CurriculumCommittee1
              Charles B. Eaton, MD, MS, Chair      Brian W. Tobin, PhD, Editor
              Lisa A. Hark, PhD, RD, Chair         Mike U. Smith, PhD, Editor
               For more information, contact:
               Charlotte Pratt, PhD, MS, RD
               NAAProgramOfficer
               National Heart, Lung, and Blood Institute
               Division of Epidemiology and Clinical Applications
               6701 Rockledge Drive
               MSC7936,Room8134
               Bethesda, MD 20892 (Overnight 20817)
               Tel.: (301) 435-0382
               Fax: (301) 480-1669
               Email: prattc@nhlbi.nih.gov
         
        Curriculum Committee Members 
        Lars Berglund, MD 
        Frances Burke, MS, RD 
        Darwin Deen, MD, MS 
        Marie Dent, PhD 
        Marilyn Edwards, PhD, RD 
        Marion Fitzgibbon, PhD 
        Frank A. Frankin, MD, PhD 
        Kim Gans, PhD, MPH, LDN 
        Joel Gordon, MD 
        Steven Havas, MD, MPH 
        Doug Heimburger, MD 
        Ronald Kahn, MD 
        Robert Knopp MD 
        Nancy Krebs, MD 
        Robert Kushner, MD 
        Tanis Mihalynuk, PhD, RD 
        Scott Mcintosh, PhD 
        Patrick, McBride, MD, MPH 
        Elizabeth Moreno, MA, MS 
        Gail Morrison, MD 
        Thomas Pearson, MD, PhD, MPH 
        Elizabeth Ross, MD 
        Craig Scott, PhD 
        Nancy Sheard, DSc 
        Mike Smith, PhD 
        Colleen Smith, PhD 
        Linda Snetselaar, PhD, RD 
        Sachiko T. St. Jeor, PhD, RD 
        Alvin Telser, PhD 
        Andrew Tershakovec, MD 
        Brian Tobin, PhD 
        Linda Van Horn, PhD, RD 
        Tracy Veach, EdD 
        Alan Walker, MD 
        Francine Welty, MD, PhD 
        Christine Williams, MD 
        Margo Woods, DSc 
        Judy Wylie-Rosett, EdD, RD 
        Charles B. Eaton, MD, MS 
         
        1 See Appendix 2 for further information on committee members, staff and contributors. 
                            
                www.nhlbi.nih.gov/funding/training/naa/guide.htm 
                 Nutrition Curriculum Guide for Training Physicians                                                 8/30/2002 
                 Practice Behavior Skills and Attitudes Across the Curriculum 
                                   Nutrition Curriculum Guide For Training Physicians 
                                                                            
                                                             Table of Contents 
                 Preface/User’s Guide 
                 Dedication 
                  
                 A.      Practice Behavior Skills Across the Curriculum  
                         A.1     Practice Behavior Skills Across the Curriculum  
                         A.2     Attitudes Across the Curriculum  
                  
                 B.      Overview  and Nutrition Basics 
                         B.1     Nutrition Principles       
                         B.2     Community and Population Health             
                         B.3     Behavioral Science Principles      
                         B.4     Nutrition Assessment       
                         B.5     Physical Activity   
                  
                 C. Lifespan   
                         C.1     Pediatrics         
                         C.2     Young Adulthood/Middle Age         
                         C.3     Geriatrics  
                         C.4     Women’s Health  
                  
                 D.      Cardiovascular System  (See also Physical Activity, Obesity, and Diabetes Mellitus)         
                         D.1     Hyperlipidemia and Atherosclerosis          
                         D.2     Hypertension       
                         D.3     Heart Failure and Cardiomyopathy            
                  
                 E. Metabolic/Endocrine Systems  
                         E.1     Obesity   
                         E.2     Diabetes Mellitus          
                  
                 F.      Other Organ Systems  
                         F.1     Gastrointestinal   
                         F.2     Hematology/Oncology  
                  F.3 Immunology   
                         F.4      Rheumatology   
                         F.5     Pulmonary          
                         F.6     Renal    
                         F.7      Bone    
                  
                 G. Other Areas  
                         G.1      Nutrition Support  
                         G.2      Contemporary Trends    
                  
                 H. Appendices 
                         H.1     Nutrition Academic Award Program Principal Investigators  
                  H.2 Nutrition Curriculum Guide for Training Physicians Contributors 
                         H.3     Description of How the Guide Was Developed 
                  
                                                                            
                 Nutrition Curriculum Guide for Training Physicians                                                 8/30/2002 
                 Practice Behavior Skills and Attitudes Across the Curriculum 
                               Nutrition Curriculum Guide for Training Physicians  
                                                      Preface/User’s Guide 
                                                                       
                 The purpose of this preface is to serve as both a brief introduction to this document and 
                 a User’s Guide to assist readers in finding the information most useful to them.  
                   
                 Background and Introduction:  In recognition of the need to develop and enhance 
                 undergraduate and graduate medical nutrition education, the National Heart Lung and 
                 Blood Institute (NHLBI) and the National Institute of Diabetes and Digestive and Kidney 
                 Diseases (NIDDK) established the Nutrition Academic Award (NAA) Program in 1997 
                 (www.nhlbi.nih.gov/funding/training/naa).  The NAA Program provided 21 U.S. medical 
                 schools with five-year grants to support nutrition education programs for medical 
                 students, medical residents, and clinical faculty (Appendix). This Nutrition Curriculum 
                 Guide for Training Physicians represents the efforts of medical nutrition educators at 
                 these schools. The section topics were selected after reviewing the existing literature 
                 and curricula. Members of the NAA Curriculum Committee were then assigned the task 
                 of creating or reviewing first drafts of a given section.  
                  
                         Each section was written with four components:  a brief list of content areas, 
                 consistent with previous curriculum recommendations for nutrition, and learning 
                 objectives written for knowledge, practice behavior skills, and attitudes. After each 
                 section was reviewed, the entire document was revised by Drs. Brian Tobin and Michael 
                 Smith at Mercer School of Medicine to ensure that the learning objectives used 
                 language consistent with Bloom’s taxonomy and included objectives that represented 
                 each area of development of expertise (cognitive and problem-solving). At this point the 
                 objectives were submitted to a consensus-generating “Delphi” process  with the 
                 assistance of Dr. Craig Scott, at the University of Washington School of Medicine. 
                  
                         Nutrition education spans the continuum for medical students, residents, and 
                 specialists and we have attempted to address this issue by listing objectives as 
                 appropriate for each of these levels. Learners at each level would be expected to have 
                 some degree of competency in those objectives listed for learners below their level. The 
                 Delphi process allowed us to prioritize objectives and we have done this by placing in 
                 BOLD type the items ranked in the top 1/3 of all objectives at each learner level. 
                 Objectives that follow are not in order of priority. Clearly, an individual programs’ ability 
                 to accomplish these objectives depends upon many factors (educational priorities, 
                 resources, etc.).  
                  
                         This curriculum is designed to be used by medical educators and evaluators, 
                 curriculum committees, Deans offices, etc. to assist in creating, evaluating, modifying, 
                 and updating nutrition curricula at individual programs (medical schools, residency and 
                 fellowship training programs). We have organized the Chapters in a way that allows 
                 individual course leaders to rapidly identify those areas relevant to their course. 
                 Curriculum committees will be most interested in the global behavior and attitude